Sirolimus Associated With Tacrolimus at Low Doses in Elderly Kidney Transplant Patients
Sirolimus Associated With Tacrolimus at Low Doses in Elderly Kidney Transplant Patients: A Prospective Randomized Controlled Trial
Studieöversikt
Status
Detaljerad beskrivning
Study Design
This will be a single-center, prospective, 12-month randomized controlled trial aiming to compare sirolimus associated with tacrolimus in elderly renal transplant patients as to safety and incidence of cytomegalovirus (CMV) infection.
Treatments
In the control group (Tacrolimus + Mycophenolate) the investigators will use tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8ng/ml at the third month and then 3-7ng/ml from the third month to the 12th month) and mycophenolate sodium 720 mg twice daily. A dose reduction of mycophenolate sodium to 720 mg/day will be accepted due to possible side effects of the drug.
In the treatment group (Tacrolimus + sirolimus) the investigators will use tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8 ng/ml at the third month and then 3-7 ng/ml from the third month to the 12th month) and sirolimus 2 mg/day (adjusted serum levels at 4-8 ng/ml throughout the study period).
In all groups, patients will receive prednisone 30 mg/day (in the first month with weekly reductions up to 5 mg/day at the end of the second month). Induction therapy consisted of basiliximab or antithymocyte globulin (Thymoglobulin, Genzyme®). Thymoglobulin will be used in patients with panel reactivity class I greater than 50 % (at a dose of 1mg/kg for 5 days).
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 4
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
1. Patients aged more than 60 years and recipients of compatible renal transplant
Exclusion Criteria:
- Receptors of multiple organs;
- non-heart beating donors;
- donors aged under 5 or over 65 years;
- Patients with body mass index greater than 35
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Enda
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Aktiv komparator: Tacrolimus + Mycophenolate
The investigators wil be used tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8ng/ml at the third month and then 3-7ng/ml from the third month to the 12th month) and mycophenolate sodium 720 mg twice daily. A dose reduction of mycophenolate sodium to 720 mg/day will be accepted due to possible side effects of the drug. Prednisone 30 mg/day in the first month. Induction therapy consisted of basiliximab or thymoglobulin if panel reactivity class I greater than 50 % |
Andra namn:
Andra namn:
Prednisone 30mg/day
Andra namn:
Basiliximab 20mg (first and fourth day) if panel reactivity class I less than 50 %
Andra namn:
Thymoglobulin at a dose of 1mg/kg for 5 days if panel reactivity class I greater than 50 %
Andra namn:
|
|
Experimentell: Tacrolimus + Sirolimus
The investigators will be used tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8 ng/ml at the third month and then 3-7 ng/ml from the third month to the 12th month) and sirolimus 2 mg/day (adjusted serum levels at 4-8 ng/ml throughout the study period). Prednisone 30 mg/day in the first month. Induction therapy consisted of basiliximab or thymoglobulin if panel reactivity class I greater than 50 % |
Andra namn:
Prednisone 30mg/day
Andra namn:
Basiliximab 20mg (first and fourth day) if panel reactivity class I less than 50 %
Andra namn:
Thymoglobulin at a dose of 1mg/kg for 5 days if panel reactivity class I greater than 50 %
Andra namn:
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Change in estimated glomerular filtration rate from baseline
Tidsram: Baseline, 1 month, 3 months, 6 months and 12 months
|
The primary end-point will be evaluated the estimated glomerular filtration rate (eGFR) over 12 months of renal transplantation.
The investigators will be measure the change in eGFR during 12 month follow-up.
Glomerular filtration rate will be estimated by the MDRD equation (Modification of Diet in Renal Disease).
|
Baseline, 1 month, 3 months, 6 months and 12 months
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of cytomegalovirus Infection (CMV)
Tidsram: Weekly from baseline until the third month. After in 4, 5, 6, 8, 10 and 12 months.
|
The secondary end-point will be evaluated the incidence of cytomegalovirus (CMV) infection.
CMV infection will be defined based on detection of CMV viral replication (CMV pp65 antigenemia more than zero) in asymptomatic patients.
CMV disease will be defined based on the evidence of CMV infection with related symptoms.
For the positive cases treatment will be carried out with ganciclovir 5 mg/kg/day twice daily adjusted for renal function for a minimum of 14 days.
|
Weekly from baseline until the third month. After in 4, 5, 6, 8, 10 and 12 months.
|
Samarbetspartners och utredare
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Virussjukdomar
- Infektioner
- DNA-virusinfektioner
- Herpesviridae-infektioner
- Cytomegalovirusinfektioner
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Anti-infektionsmedel
- Enzyminhibitorer
- Antiinflammatoriska medel
- Antineoplastiska medel
- Immunsuppressiva medel
- Immunologiska faktorer
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitut och hormonantagonister
- Antineoplastiska medel, hormonella
- Antibakteriella medel
- Antibiotika, antineoplastiska
- Antifungala medel
- Antituberkulära medel
- Antibiotika, Antituberkulära
- Calcineurin-hämmare
- Prednison
- Takrolimus
- Mykofenolsyra
- Sirolimus
- Basiliximab
- Thymoglobulin
- Antimfocytserum
Andra studie-ID-nummer
- 16966913.6.0000.5411
Plan för individuella deltagardata (IPD)
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